Association of poverty and sexually transmitted infections among youth diagnosed with mental illness

Objectives: To determine the association of poverty and laboratory-confirmed prevalence of sexually transmitted infections (C. trachomatis, T. vaginalis, and Neisseria gonorrhoeae) among youth diagnosed with mental illness. Methods: Sexually experienced youth (ages 13-18 years) recently diagnosed with a psychiatric disorder, and willing to be tested for STIs, were recruited from three U.S. cities (N = 322). Self-reported measures were collected using audio-computer assisted self-interviewing. DNA amplification was used to detect the presence of C. trachomatis, T. vaginalis, and Neisseria gonorrhoeae. Results: Fifty youth (15.5%) tested positive for one or more of the assessed STIs. City of recruitment (P = .12), and age (P = .38) were not associated with STI prevalence. However, prevalence was greater among non-white youth (P = .03) and females (P = .001). After controlling for these two demographic variables, youth reporting that “lots of poor people” lived in their neighborhoods were significantly more likely (P = .01) to test positive for an STI (22.0%) compared to those not indicating that lots of poor people lived in their neighborhoods (11.7%). Psychosocial constructs such as self-efficacy for HIV prevention (P = .15), parental monitoring (P = .23), and impulsivity (P = .43) were not associated with STI prevalence. Conclusion: Among a youth recently diagnosed with psychiatric disorders, findings demonstrate that STIs are more common among those living in poverty. Where youth live may be more important than psychosocial constructs in predicting their risk of STI acquisition.